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Fluoxetine and congenital malformations: a systematic review and meta‐analysis of cohort studies

British journal of clinical pharmacology, 2017-10, Vol.83 (10), p.2134-2147 [Peer Reviewed Journal]

2017 The British Pharmacological Society ;2017 The British Pharmacological Society. ;ISSN: 0306-5251 ;EISSN: 1365-2125 ;DOI: 10.1111/bcp.13321 ;PMID: 28513059

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Title:
Fluoxetine and congenital malformations: a systematic review and meta‐analysis of cohort studies
Author: Gao, Shan‐Yan ; Wu, Qi‐Jun ; Zhang, Tie‐Ning ; Shen, Zi‐Qi ; Liu, Cai‐Xia ; Xu, Xin ; Ji, Chao ; Zhao, Yu‐Hong
Subjects: Abnormalities, Drug-Induced - epidemiology ; Abnormalities, Drug-Induced - etiology ; antidepressants ; Antidepressive Agents, Second-Generation - adverse effects ; birth defects ; cardiovascular ; depression ; Depression - drug therapy ; Female ; Fluoxetine - adverse effects ; Heart Septal Defects - chemically induced ; Heart Septal Defects - epidemiology ; Humans ; Incidence ; Infant ; meta‐analysis ; Pregnancy ; Pregnancy Complications - drug therapy ; Pregnancy Trimester, First ; Publication Bias ; Systematic Review and Meta–Analysis
Is Part Of: British journal of clinical pharmacology, 2017-10, Vol.83 (10), p.2134-2147
Description: Aims To investigate the safety of fluoxetine use during pregnancy, and to better understand the relationship between maternal fluoxetine use during the first trimester and congenital malformations in infants. Methods PubMed and Web of Science databases were systematically searched from inception to 21 March 2016. Additional studies were identified in a manual search of the reference lists. Two reviewers independently extracted data. A third reviewer checked the data. Estimates were pooled using a random‐effects model to calculate the summarized relative ratios (RR) and 95% confidence intervals (CI). Results Among 1918 initially identified articles, 16 cohort studies were included. The offspring of pregnant women exposed to fluoxetine during the first trimester had a statistically increased risk of major malformations (RR = 1.18, 95% CI = 1.08–1.29), cardiovascular malformations (RR = 1.36, 95% CI = 1.17–1.59), septal defects (RR = 1.38, 95% CI = 1.19–1.61), and non‐septal defects (RR = 1.39, 95% CI = 1.12–1.73) with low heterogeneity in infants. There were no significant observations of other system‐specific malformations in the nervous system, eye, urogenital system, digestive system, respiratory system, or musculoskeletal system, respectively. There was no indication of publication bias. Conclusions The results of this meta‐analysis indicate maternal fluoxetine use is associated with a slightly increased risk of cardiovascular malformations in infants. Health care providers and pregnant women must weigh the risk–benefit potential of these drugs when making decisions about whether to treat with fluoxetine during pregnancy.
Publisher: England: John Wiley and Sons Inc
Language: English
Identifier: ISSN: 0306-5251
EISSN: 1365-2125
DOI: 10.1111/bcp.13321
PMID: 28513059
Source: GFMER Free Medical Journals
MEDLINE
PubMed Central

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Fluoxetine and congenital malformations: a systematic review and meta‐analysis of cohort studies

2017 The British Pharmacological Society ;2017 The British Pharmacological Society. ;ISSN: 0306-5251 ;EISSN: 1365-2125 ;DOI: 10.1111/bcp.13321 ;PMID: 28513059

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